title: Optimal use of acute headache medication: a qualitative examination of behaviors and barriers to their performance.
abstract: OBJECTIVE
  This study aims to qualitatively examine the behaviors required to optimally use acute headache medication and the barriers to successful performance of these behaviors.
  
  
  BACKGROUND
  The efficacy of drug treatment is partly determined by medication adherence. The adherence literature has focused almost exclusively on the behaviors required to optimally use medications that are taken on a fixed schedule, as opposed to medications taken on an as needed basis to treat acute episodes of symptoms, such as headaches.
  
  
  METHODS
  Twenty-one people with headache and 15 health care providers participated in qualitative phenomenological interviews that were transcribed and coded by a multidisciplinary research team using phenomenological analysis.
  
  
  RESULTS
  Interviews revealed 8 behaviors required to optimally use acute headache medication, including cross-episode behaviors that people with headache regularly perform to ensure optimal acute headache medication use, and episode-specific behaviors used to treat an individual headache episode. Interviews further revealed 9 barriers that hinder successful performance of these behaviors.
  
  
  CONCLUSIONS
  Behaviors required to optimally use acute headache medication were numerous, often embedded in a larger chain of behaviors, and were susceptible to disruption by numerous barriers.
authors.affiliation: VA Connecticut Healthcare System, West Haven, CT, USA; Yale School of Medicine, New Haven, CT, USA.
authors.forename: Elizabeth K
authors.initials: EK
authors.lastname: Seng
authors.forename: Kenneth A
authors.initials: KA
authors.lastname: Holroyd
mesh_terms: D000208:Acute Disease; D000328:Adult; D000700:Analgesics / Q000627:therapeutic use*; D005260:Female; D006261:Headache / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D011795:Surveys and Questionnaires / Q000592:standards*; D055815:Young Adult
chemical_list: D000700:Analgesics
keywords: acute medication; headache; medication adherence; qualitative